Chapter XI: Appendix: A

DIRECTIONS FOR RESTORING THE APPARENTLY DEAD FROM DROWNING.

(_Reprinted by permission from the Directions issued by the Royal Humane Society._)

As soon as the body is taken out of the water, lay it on the ground, wipe it dry, and let the wind blow freely upon the surface. With this view, on no account let people crowd round the body.

The points to aim at are—first, and immediately, the RESTORATION OF BREATHING; and secondly, after breathing is restored, the PROMOTION OF WARMTH AND CIRCULATION.

Treatment to Restore Natural Breathing.

RULE 1.—_To maintain a Free Entrance of Air into the Windpipe._—Cleanse the mouth and nostrils;[3] open the mouth; draw forward the patient's tongue, and keep it forward; an elastic band over the tongue and under the chin will answer this purpose. Remove all tight clothing from about the neck and chest.

RULE 2.—_To adjust the Patient's Position._—Place the patient on his back on a flat surface, inclined a little from the feet upwards; raise and support the head and shoulders on a small firm cushion or folded article of dress placed under the shoulder blades.

RULE 3.—_To imitate the Movements of Breathing._—Grasp the patient's arms just above the elbows; and draw the arms gently and steadily upwards, till they meet above the head (this is for the purpose of drawing air into the lungs), and keep the arms in that position for two seconds. Then turn down the patient's arms, and press them gently and firmly for two seconds against the sides of the chest. _See_ Engravings I. and II. (This is with the object of pressing air out of the lungs. Pressure on the breastbone will aid this.)

Repeat these measures alternately, deliberately, and perseveringly, fifteen times in a minute, until a spontaneous effort to respire is perceived, immediately upon which, cease to imitate the movements of breathing, and proceed to INDUCE CIRCULATION AND WARMTH (_as below_).

Should a warm bath be procurable, the body may be placed in it up to the neck, continuing to imitate the movements of breathing. Raise the body in twenty seconds in a sitting position, and dash cold water against the chest and face, and pass ammonia under the nose. The patient should not be kept in the warm bath longer than five or six minutes.

RULE 4.—_To excite Inspiration._—During the employment of the above method excite the nostrils with snuff or smelling salts, or tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them.

Treatment after Natural Breathing has been Restored.

RULE 5.—_To induce Circulation and Warmth._—Wrap the patient in dry blankets and commence rubbing the limbs upwards, firmly and energetically. The friction must be continued under the blankets or over the dry clothing.

Promote the warmth of the body by the application of hot flannels, bottles or bladders of hot water, heated bricks, &c., to the pit of the stomach, the armpits, between the thighs, and to the soles of the feet. Warm clothing may generally be obtained from bystanders.

On the restoration of life, when the power of swallowing has returned, a teaspoonful of warm water and subsequently small quantities of wine, warm brandy and water, or coffee should be given. The patient should be kept in bed, and a disposition to sleep encouraged. During reaction large mustard plasters to the chest and below the shoulders will greatly relieve the distressed breathing. Great care is requisite to maintain the restored vital actions, and at the same time to prevent undue excitement.

The above treatment is to be persevered in for three or four hours, or until the pulse and breathing have ceased for at least one hour. It is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance; as cases are on record of a successful result even after five hours' perseverance in the use of the above means.

APPEARANCES WHICH GENERALLY INDICATE DEATH.

There is no breathing or heart's action; the eyelids are generally half closed; the pupils dilated; the jaws clenched; the fingers semi-contracted; the tongue appearing between the teeth, and the mouth and nostrils are covered with a frothy mucus. Coldness and pallor of surface increase.

[Footnote 3] A good plan is to turn the body gently over for a few seconds with the face to the ground, one of the hands being placed under the forehead. By this means the water will run out of the mouth and the tongue will fall forward, leaving the breathing opening free. On no account should the body be held up by the feet as has been advised by some old writers.